Book Club: Her Body, Our Laws

By 2014, law professor Michelle Oberman was no stranger to El Salvador. She had already spent four years making research trips to the Central American country, but that June she would need a local guide during her travels. An activist had volunteered to accompany her on the interview she needed to conduct, a task that required a two-and-a-half-hour trip outside the city to an area that is not well mapped — in fact, to a village where there are “no signs or numbers” to help visitors find their way among the cinder-block houses and the patchwork of land where the clucks and lowing of livestock punctuate the silence.

Once in the village, it took Oberman and her guide an additional 45 minutes to find the house they needed to visit. Inside, a curtain was all that separated the main room from a small bedroom in the back. A bucket and outdoor basin served as a shower, and an outhouse completed the bathroom facilities. The living conditions there were not uncommon — not in a country where roughly 40 percent of the population lives in poverty.

In the early 1980s, the small republic of El Salvador was in the grip of civil war, while in the U.S., debates raged over the emerging Sanctuary Movement that was aiding Salvadoran and other Central American refugees. The movement began in 1981, when Quaker activist Jim Corbett and Presbyterian Pastor John Fife, both of Tucson, pledged to “protect, defend, and advocate for” the many people fleeing warfare and political turmoil in El Salvador and neighboring countries. Tucson was at the forefront of the movement as refugees crossed through Mexico and arrived at the Arizona border.

The religious right would arrive at its own interest in El Salvador — but for very different reasons than the Sanctuary Movement. As El Salvador rebuilt after years of warfare and political strife, the Catholic Church filled much of the power void, exercising considerable influence over reproductive rights and other policies that affected women. It led, in 1998, to a complete ban on abortion, removing exceptions for rape or medical conditions that put a mother’s life at risk. In turn, Christian conservatives in the U.S. have looked at El Salvador as both a model and a testing ground, a place where they can promote tougher abortion laws than they can at home. Many have provided their counterparts in El Salvador with model legislation, propaganda, practical guidance, strategic funding, and other assistance to uphold and strengthen the ban.

How El Salvador’s abortion laws developed tells one story, but Oberman focuses on another. Her Body, Our Laws is a slim volume — only 144 pages without its bibliographical notes and index — and it largely bypasses the kind of background details like the ones above. Instead, the book zeroes in on the outcomes of El Salvador’s strict ban, and what those outcomes can tell us about the debate over abortion. To answer that question, Oberman traveled extensively and interviewed physicians, activists, and lawyers. Later, she repeated much the same process in the United States, visiting Oklahoma, one of the most anti-abortion states in the union, to put our own abortion laws under the microscope.

Laws, Myths, and Reality in Latin America

In her introduction, Oberman explores many of the paradoxes that surround abortion laws, recounting stories she learned in college, when she spent Saturdays volunteering for Planned Parenthood, and later, when she started collecting accounts “from drug rehabilitation centers, from doctors, from child abuse experts, and from women themselves.” As “a collector of stories,” Oberman began to realize that there are many women “who live in a chaos so profound that despair predates the unplanned pregnancy” and for whom “the notion of a planned pregnancy is itself almost meaningless.”

To those women, the option to terminate a pregnancy, even if entirely legal, “hardly mattered” amid other circumstances that were beyond their control. Oberman met women who carried their pregnancies to term, only to see their children die at the hands of an abusive partner or under some other tragic circumstance.

Those paradoxes sent Oberman on a quest to answer what abortion’s legality — or illegality — really means. That quest took her to Chile in 2008, a country that, like El Salvador, has some of the strictest anti-abortion laws in the Western Hemisphere. There, she found that illegal abortion medications were readily available, and convictions for either buying or selling them were a rarity. Though it may be cold comfort for abortion-rights advocates, there was also a surprisingly low fatality rate from those self-administered, illegal abortions.

“My body, my rights.” Graffiti near the University of El Salvador.

The following year, Oberman traveled to a binational conference of activists and advocates who were working to lift abortion restrictions in Nicaragua and El Salvador. The attendees from the latter nation shared accounts that made it clear that their nation, unlike Chile, was zealous about enforcing its abortion restrictions, imprisoning “scores of women” for violating the laws.

The combination of strict laws and strict enforcement compelled Oberman to make El Salvador the subject of more intensive research. Oberman’s nine subsequent trips to El Salvador revealed the extremes its abortion laws could reach. In one visit, she met a physician who explained his protocol for dealing with an ectopic pregnancy. Unlike a normal pregnancy that develops in the uterus, in an ectopic pregnancy the fetus attaches somewhere else, most commonly in one of the mother’s fallopian tubes. The result is a fetus that is not viable, and one that could rupture an organ if left to develop. Even so, under Salvadoran law, which dictates that life begins at conception, removing an ectopic fetus before it is critically necessary for the mother’s health is potentially punishable under the law. Going against medical principles for virtually any other condition, physicians have to wait until the situation worsens to the point of being life-threatening to the mother.

Back in the isolated village she visited in 2014, in a dimly lit dwelling furnished with lawn chairs and two hammocks, Oberman interviewed Beatriz García, a woman whose situation the year before had underscored the dangerous consequences of an extreme abortion ban. Her case sparked an international campaign to grant her amnesty and end the abortion ban.

García had both lupus and kidney problems, and her blood pressure meant that the risk of stroke was always present. As such, her pregnancy was life-threatening. García already had one child, and during that pregnancy she had suffered anemia, pneumonia, and preeclampsia. It had furthermore been determined that her fetus was anencephalic, or developing without a brain, meaning that if were carried to term, it would only survive a few hours after birth. With the support of feminist and human rights groups in El Salvador and around the globe, García petitioned the Salvadoran Supreme Court to direct medical personnel to proceed with abortion services — and to provide them assurances there would be no criminal consequences for doing so. García lost her case, but she did survive her pregnancy. Her baby, born on June 3, 2013, lived for five hours after its birth.

“We are still far from reaching universal access to reproductive health, that is to say, the well-being that all women should have.” Display (detail) at the Museo de la Palabra y la Imagen.

Though El Salvador’s abortion ban is strictly enforced, unlike Chile’s ban that is largely ignored, Oberman argues the outcome is still largely the same. El Salvador’s birth rate is no higher now than it was before the ban took effect in 1998 — and it’s not significantly different from the birth rate found in neighboring countries, like Costa Rica and Panama, where laws are more permissive.

There is, furthermore, no evidence that the abortion rate has decreased in El Salvador. The ban’s only outcome has been pushing urban women, at least those who have the financial means, to seek illegal abortion medications online. Women who are poorer or who live in rural areas, on the other hand, “continue to use coat hangers.”

At the same time, the profile of those who become mothers has changed, as El Salvador has gained the distinction of having the highest rate of unwed teen motherhood in the world. The consequences of the country’s high teen pregnancy rate are reflected in maternal death statistics; 3 out of 8 deaths are the result of suicide among pregnant girls under the age of 19.

Making Sense of the Sooner State

The second portion of Oberman’s book takes readers to Oklahoma, where Roe v. Wade is still the law of the nation, but state legislators pass whatever bills they can to nullify the protections the 1973 decision guarantees. Though many legislators evaded her requests for an interview, what she found in the few she was granted were politicians who were looking for personal moral expression in anti-abortion laws — and who in many cases seemed disinterested in their real-life consequences. They were people who lacked a coherent vision of how a complete criminalization of abortion would even look. That made them simultaneously reckless in dealing with the lives of women and, at times, ineffective at achieving their purported aims. For example, Oberman argues that a law on sex-selective abortion was “plainly symbolic” in a state where patients aren’t required to declare a reason for seeking an abortion.

Oberman concludes her book by arguing that abortion laws — whether in El Salvador, Oklahoma, or anywhere else — have in many respects taken on an oversized importance. For many women, the most immediate and lasting considerations are the many “competing costs” of motherhood and abortion, and the question of legality often lacks the decisive power implied by the slogans and talking points from both sides of the abortion debate.

Here, Oberman tries to be even-handed, offering criticism of abortion-rights advocates and abortion opponents alike. However, her criticisms of the former group are mild. She argues that the coat-hanger imagery used by activists in the U.S. is outdated and overstates the lethal consequences of anti-abortion laws, especially in a nation where black-market abortion medications and “abortion tourism” would likely become commonplace in a post-Roe America. She argues, too, that if they looked past the “broad generalities” and flat depictions, they may find common cause with people on the other side of the debate. She offers as an example the women at Birth Choice of Oklahoma, who provide nonjudgmental support to women who decide to keep their pregnancies.

Where Oberman seems to find the greater folly is with abortion opponents, whose use of slogans like “Stop Abortion Now” is out of touch with how ineffective any laws against abortion have been. It was a fact that was made apparent over and over again in Chile and El Salvador. She offers, as a more realistic assessment of how to curtail abortion, the observation of Barbara Chisko, the executive director of Birth Choice of Oklahoma: “the bottom line encourages abortion.” As Oberman paraphrases, “Work, school, ability to care for others, and money” are the truly decisive factors. Oberman argues that the policies that determine those factors may provide a truer reflection of a government’s priorities. She points to the nations of Western Europe, where guaranteed paid maternity leave, monthly child allowances, and affordable day care and health care make the “competing costs” of motherhood considerably less. In Western Europe, family-friendly policies are one of the factors that give the region one of the lowest abortion rates in the world.

Her Body, Our Laws provides a collection of personal accounts, professional opinions, and health data as varied as the places the author visited and the people she met in the course of researching it. They are all presented, though, with a legal scholar’s ability to find unifying themes and overarching truths.

Oberman’s book offers clarity to a polarizing issue — not by cutting through the complexity, but by taking it all in, acknowledging the nuances that are lost in many debates, and imploring the reader to do the same. Oberman makes a strong case that doing anything less does a disservice to the women — and their partners — for whom the abortion debate is more than just a platform for the assertion of abstract principles.

Photo Credits and Translations

The author of this review traveled to El Salvador in January 2018, and the photos that appear after the book cover image are his. The translations provided below are his as well. For the sake of readability, liberties were taken with punctuation and capitalization in the transcription and translation of the third photo.

Photo 3: “Mi cuerpo, mis derechos”
Street graffiti south of the University of El Salvador. The graffiti translates as, “My body, my rights.” Though this and similar expressions are used in the U.S. when asserting abortion rights, the stenciled graffiti directly below (not pictured) reads, “Con falda o pantalón, respétame, cabrón” (an expression that loses its rhyme and melody in translation: “[Whether I’m] in a skirt or pants, respect me, asshole!”); thus, the expression here appears to be addressing unwelcome sexual advances.

Photo 4: “Todavía estamos lejos de alcanzar el acceso universal a la salud reproductiva, es decir, la condición de bienestar que toda mujer debe tener.”
Detail from a display at the Museo de la Palabra y la Imagen (Museum of the Word and Image), a museum devoted to the Salvadoran civil war and the broader struggle for economic, social, and civil rights. The caption translates as, “We are still far from reaching universal access to reproductive health, that is to say, the well-being that all women should have.”

About Matt

Matt has a background in human services, health disparities research, and administrative support at an academic health sciences center. In addition to Planned Parenthood Advocates of Arizona, he volunteers with Read Between the Bars, a program that sends books to people in Arizona’s prisons. In his free time, he enjoys reading, studying Spanish, and playing Scrabble.